Active NPI
Matthew Paul Mignogna, O.D.
- Optometrist
- Whitehall, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OE-007828-T
- Practice address
- 706 Grape St
Whitehall, PA 18052-5207 - Phone
- (610) 266-7700
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OE-007828-T | PA | Primary |
Addresses
Primary practice location
706 Grape St
Whitehall, PA 18052-5207
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200401000529 | PA | Practitioner - Optometry | 9335578038 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Myeyedr Optometry of Pennsylvania LLC
Practice addresses (Care Compare)
706 Grape St
Whitehall, PA 18052-5207
Phone (610) 266-7700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OE-007828-T | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Pennsylvania, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Pennsylvania, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Pennsylvania, LLC | Optometrist | Current | Accepting new patients |
Locations
125 S Antrim Way
Greencastle, PA 17225
Phone (717) 597-4780
2842 S Eagle Rd
Newtown, PA 18940
Phone (215) 579-1155
706 Grape St
Whitehall, PA 18052
Phone (610) 266-7700
1950 Old Gallows Rd
Ste 520
Vienna, VA 22182
8614 Westwood Center Dr
Fl 9
Vienna, VA 22182
Organizations & group practices 15
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727308800000",
"number": "1164522124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8614 WESTWOOD CENTER DR FL 9",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822442",
"telephone_number": "703-847-8899",
"fax_number": "571-223-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 GRAPE ST",
"city": "WHITEHALL",
"state": "PA",
"postal_code": "180525207",
"telephone_number": "610-266-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIGNOGNA",
"first_name": "MATTHEW",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2024-09-26",
"certification_date": "2024-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OE-007828-T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Whitehall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.